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Query: UMLS:C0032285 (pneumonia)
 54,520 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Four patients with very severe aplastic anemia refractory to antilymphocyte globulin were administered recombinant human granulocyte-macrophage--colony stimulating factor (GM-CSF). One patient with minimal residual myelopoiesis responded transiently to two separate courses of GM-CSF at 4 and 8 micrograms/kg/d administered intravenously and another course at 4 micrograms/kg/d administered subcutaneously. Septicemia and bilateral pneumonia that had been resistant to conventional therapy resolved. Three patients with no evidence of residual myelopoiesis did not respond to GM-CSF. In one patient, the dose was increased to 32 micrograms/kg/d with no effect on hematopoiesis. Immediate side effects were minimal at GM-CSF doses up to 16 micrograms/kg/d. GM-CSF may, however, have been involved in the pathophysiology of thrombosis of the inferior vena cava in the patient administered 32 micrograms/kg/d. We conclude that GM-CSF does not induce hematopoiesis in long-standing, severe, treatment-resistant aplastic anemia with complete myelopoietic failure. However, in patients with minimal residual myelopoiesis, GM-CSF could be a promising adjuvant therapy for severe infection.
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PMID:Failure of recombinant human granulocyte-macrophage colony-stimulating factor therapy in aplastic anemia patients with very severe neutropenia. 326 96

Twenty-two patients admitted to the ICU with a severe nosocomial infection caused by multi-resistant Gram-negative bacilli were treated with imipenem combined with cilastatin. We treated nine cases of meningo-ventriculitis, eight cases of septicaemia, four cases of mediastinitis, and one case of pneumonia. The bacteria responsible were Acinetobacter spp. (10), Pseudomonas aeruginosa (5), Enterobacter cloacae (5), Klebsiella pneumoniae (3), Proteus spp. (2), Streptococcus spp. (2), Serratia marcescens (1). More than one pathogen was isolated in five cases. The dosages ranged between 1.5 g to 4 g per day by intravenous infusion; the highest doses were used for the treatment of meningitis. The mean duration of treatment was 17 days. An aminoglycoside was combined with imipenem in 18 cases. Cure was obtained in 17 out of the 22 cases. Very rapid sterilization of the CSF in the cases of meningitis and ventriculitis was noted. Two patients died rapidly despite eradication of the bacteria. One case of meningitis relapsed but cure was subsequently obtained with continuation of the same treatment. In three cases of Ps. aeruginosa infection, resistant mutants were isolated from the sites of infection and were responsible for two failures and one colonization. Imipenem appears to be an antibiotic of choice in severe nosocomial infections including meningo-ventriculitis, especially those caused by Acinetobacter spp. and Ps. aeruginosa. It is also one of the few antibiotics active against both streptococci and multi-resistant Gram-negative bacilli. Careful bacteriological monitoring is recommended during treatment.
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PMID:Experience with imipenem/cilastatin in the intensive care unit. 346 88

Ceftazidime was prospectively evaluated in the treatment of bacterial meningitis in 19 pediatric patients. Haemophilus influenzae type b (HIB) was the etiologic agent in 17 patients, and Streptococcus pneumonia and Neisseria meningitidis were the etiologic agents in one patient each. Ceftazidime was administered intravenously in a dosage of 150 mg/kg/day divided into eight hourly doses for a mean of 15 days (range, 14 to 22 days) for H. influenzae type b meningitis. The clinical and microbiologic response was appropriate in all cases. The mean ceftazidime CSF concentration was 6.7 micrograms/ml at approximately 2 hours following iv infusions. This concentration was 16- to greater than 100-fold the minimal bactericidal concentration determined for the isolated pathogens. These preliminary observations support ceftazidime as a candidate cephalosporin for the treatment of bacterial meningitis caused by H. influenzae. Additional study is required to further define its role in meningitis caused by S. pneumoniae and N. meningitidis.
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PMID:Treatment of bacterial meningitis with ceftazidime. 352 58

Between January of 1983 and December 1984, 11 strains of pneumococci resistant to penicillin were isolated, from a total of 46 strains studied with clinical signification, thus accounting for 23.9%. In nine cases (19.5%) pneumococci showed partial resistance to penicillin and in two strains (4.3%) resistance was total. Pneumococcal disease in our 11 patients was demonstrated by blood culture in 7 cases and by culture of the CSF, in 4. Diagnosis of the patients were as follows: 4 sepsis in immunosuppressed host, 2 bacteremia without an evident focus, 1 pneumonia, 3 meningitis and 1 ventriculitis. Vancomycin and rifampin are the most active in this cases. Some of the new cephalosporins of the third generation (cefotaxime and ceftriaxone) and cefuroxime have a good activity in vitro and a good passage to the CSF.
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PMID:[Pneumococci resistant to penicillin]. 360 77

A review and follow-up study of 21 Chinese infants who had pneumococcal meningitis showed a mortality of 23.8% and high morbidity in survivors. Severe meningitis and delay in treatment as reflected by the presence of coma, pneumonia, disseminated intravascular coagulation, and lumbar CSF protein of over 368 mg% and glucose of lower than 10 mg% at the time of diagnosis were associated with fatality. Although the pneumococcus was sensitive to Penicillins which were given at usually recommended dosages and duration in these infants, the morbidity in survivors was high, and seemed to be associated with the presence of focal neurological abnormalities at the time of diagnosis, slow response in fever to treatment, short duration of afebrile period before discontinuation of antibiotics, and incompletely normal CSF parameters at the time of cessation of antibiotics. Serially sterile lumbar CSF did not guarantee against recrudescence of meningitis after cessation of antibiotics. The lack of uniformity in treating and monitoring these patients and suggested management are discussed.
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PMID:Pneumococcal meningitis in infants. 383 49

The authors have carried out the pharmacokinetic and clinical studies of cefminox (CMNX, MT-141). The results were as follows: CMNX was given by intravenous drip infusion for 1 hour at a dose of 20 mg/kg b.w. to 2 children. The serum levels of CMNX were 103.02 micrograms/ml and 77.73 micrograms/ml at 1 hour after drip infusion, and the levels at 7 hours were 4.39 micrograms/ml and 4.19 micrograms/ml, respectively. The half life times were 1.20 hours and 1.32 hours, respectively. CSF concentrations of CMNX at 1 hour after drip infusion of a dose of 50 mg/kg in 3 patients with aseptic meningitis were 1.68 micrograms/ml (d.i. for 30 minutes), less than or equal to 0.25 micrograms/ml (d.i. for 1 hour) and 0.51 micrograms/ml (d.i. for 1 hour), respectively. CSF/serum ratios were 1.1% and 0.6%. Clinical efficacy was evaluated in 10 cases with purulent tonsillitis (3 cases), pneumonia (3 cases), pyelonephritis (1 case) and enteritis (3 cases). Excellent and good responses were obtained in all cases. Bacteriological response in the form of eradication was noted 8 of 9 cases. No side effects were observed.
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PMID:[Laboratory and clinical studies of cefminox in the pediatric field]. 383 62

Four patients with acute leukemias resistant to various ARA-C containing regimens and one patient with rapidly progressive malignant nonseminomatous tumor of the testis, who failed to conventional therapy were treated with HD ARA-C from december 1979 to september 1980. The drug was monitored by HPLC in plasma and in CSF. The first patient received only one course of HD ARA-C, developed fever and died of septicemia ten days later. The leucocyte count of her AML (FAB 2) decreased from 120,000/microliter to 30,000/microliter on the third day after HD ARA-C. Patient 2 reached CR criteria of the bone marrow for 23 days, then resistant AML (FAB 2) recurred. A male patient of 30 years was treated for recurrent acute undifferentiated leukemia (AUL) with a high cumulative dose of 176 gs of ARA-C. The repeated courses of treatment included a period of 50 days of CR. Toxicity was remarkable including pulmonal and cerebral dysfunction. A fourth patient with monocytic leukemia did not respond to HD ARA-C, neither did the patient with the malignant teratoma. Adverse reactions were tolerable. Only the third patient suffered from severe toxicity, pneumonitis, blurring vision, cerebral dysfunction and dermatitis. His pretreatment regimen had included X-ray prophylaxis to the skull. Since there was no possibility to prolong the remission duration in 1980, we decided not to treat further patients with HD ARA-C. Nowadays bone marrow transplantation offers some patients a capability of eradication of the leukemic disease.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Results of therapy with high-dose cytosine arabinoside]. 388 22

Among 16 cases of measles encephalitis observed in Toronto during 1964 and 1965, including six who were stuporous or comatose on admission and five who presented with convulsions, measles virus was isolated from CSF of one patient, rising titres of measles antihemagglutinin were detected in another patient, and 14 showed high antibody titres in sera collected as early as two to five days after onset of the measles rash. Increasing levels of measles antibody were detected in paired sera from three of seven patients with uncomplicated measles, and elevated antihemagglutinin titres were found in 16 cases of measles without neural involvement. Measles virus was isolated from lung tissue of a fatal case of giant cell pneumonia. Administration of pooled human gamma globulin to one leukemic patient, and of leukocytes from a convalescent donor to another leukemic child, may have assisted their recovery from measles.
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PMID:Viral infections of Toronto children during 1965: II. Measles encephalitis and other complications. 495 71

Aminoglycosides still play a major role int e treatment of severe infections, especially those due to Gram-negative bacilli. They are usually administered together with a beta-lactam antibiotic, either to cover a wide antibacterial spectrum, or to obtain a better bactericidal effect, or to prevent the emergence of resistant mutants. They are mainly used in severe urinary tract infections and/or in those due to multiresistant organisms and in Gram-negative pneumonia and meningitis (intrathecally, since they poorly diffuse into the CSF). Combined with cephalosporins they constitute the first-line treatment of severe, life-threatening infections caused by Gram-negative aerobes. Given simultaneously with penicillinase-resistant semi-synthetic penicillins or with vancomycin they act synergistically against staphylococci and can be used initially for a few days in the treatment of severe staphylococcal infections. It is also for this synergistic action that they are combined with penicillin G or ampicillin in the treatment of endocarditis. The ototoxic or nephrotoxic effects common to all aminoglycosides can be avoided by adjusting the doses to the degree of renal function, by limiting their use to about a fortnight (except for endocarditis) and by monitoring blood levels.
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PMID:[Current therapeutic indications of aminoglycosides]. 623 28

Cefotiam (CTM) was evaluated for its safety and efficacy in children. Twenty-six patients were treated with 40 to 200 mg/kg per day of CTM by intravenous administrations. The diagnosis of the patients were acute pharyngitis (2), acute bronchitis (1), pneumonia (4), empyema (2), urinary tract infection (2), typhoid fever (1), acute enterocolitis (2), partially-treated purulent meningitis (1), and suspected septicemia in neuroblastoma (1); and the remaining ten patients were considered to have nonbacterial infections. The pathogens recovered were Streptococcus pyogenes (1), Streptococcus pneumoniae (1), Staphylococcus aureus (4), Haemophilus influenzae (4), Escherichia coli (1), enteropathogenic Escherichia coli (1), Salmonella typhi (1), and Campylobacter jejuni (1). All but two patients of bacterial infections were cured after the CTM therapy, and the rate of efficacy was 87.5%. Diarrhea (3), urticaria (1), transient elevation of GOT and GPT (1), and transient eosinophilia (3) were found to be associated with the CTM therapy. However, no severe adverse reactions were encountered. Half life of the serum CTM level was 0.93 +/- 0.13 hours, and excretion into the urine was rapid. CSF concentration obtained 1 hour after an intravenous injection of 21 mg/kg of CTM in a case with inflamed meninges was 1.5 mcg/ml, and the CSF/serum ratio was 9.0%. From these data, CTM appears to be a safe and effective antibiotic when used in children with susceptible bacterial infections.
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PMID:[Clinical evaluation of cefotiam therapy in children (author's transl)]. 627 Apr 13


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